Provider Demographics
NPI:1730439365
Name:HAMMOND, SAMANTHA BYNUM (LICSW)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:BYNUM
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:TAYLOR
Other - Last Name:BYNUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30 WINNACUNNET RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03842-2121
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:30 WINNACUNNET RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842-2121
Practice Address - Country:US
Practice Address - Phone:603-726-1855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 104100000X
NH23601041C0700X
CA781171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA78117OtherBOARD OF BEHAVIORAL SCIENCES